H. R. 676 NOW!

The reason the wingnuts and Medical industrial is because it's a real way to lower costs. Lowering cost is one of the real ways we can save the system as it is.

To stop the down right scaming(useing treatments they know will not work to up the bill) by many hospidals is something that should be done, but these groups don't want to stop because it will lower profits.

I am in medical school by way of justifying why anyone would care about my opinion.

The trend is to use evidence based approaches to medicine and move away from consensus. That means standards of care are based on what we can demonstrate works (or has more benefit than harm as there is often a mix) as opposed to what we think works (or what the dean at the closest medical college thinks works as has been historically the case.)

Additionally, there is a question of distributing resources. For example, enzyme-replacement therapy is fairly safe and effective in some vanishingly rare disorders, but costs 1000's of dollars per month for life. At some point, sadly, in a publicly funded program one must decide whether we can afford to support all the newest designer therapies.

I don't think the idea is to take decision making out of the hands of MD's and patients. I think it is merely to say what the government will pay for or won't. And really, that has always been the case hasn't it?

So the question on whether this type of commission is complicated, and really I couldn't judge whether it is good or bad until it is clearer what the mandate is.

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It's too bad America never gets a straight up/down vote on these items. Instead, they get packaged into a larger Amendment which eventually raises the ire of someone as to why the original bill should be voted down. It's an unfortunate outcome to the watering down of good legislation.

If there were a "Health Care bill" that these Cretans were discussing, then yes, America could have a good healthy debate about the future of their health care. But no, this is about an Amendment that has been attached to a wholly and completely different bill.

When Legislators quit being bureaucrats, Good bills can become laws.

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I have no problem with data being collected to show which treatments in which situations are most effective. Its actually a kind of no-brainer. Should have been done already.

Problem is what they do with the data.

Example: I go to the doctor with problem A. Doc examines me and says, based on his experience and examination, he's going to recommend treatment B. Problem is my HMO looks at the govt study and says, you know, treatment C is cheaper and is shown to be more effective, SO they won't pay for treatment B. The problem of course is I'm not a statistic and really assuming my doctor is honest, his judgment should be the determinant factor. Now I'm dead cause my doctor was right and the HMO effectively practiced medicine off of a govt report and the CEO gets to buy himself another roll of extra extra soft toilet paper to wipe is rich ass.

that if the Coulter and Beck video were the headline for the post instead nof "Feds will compare" the response rate qould be qaudrupled.

This wont be fair with autism either, Partly because they STILL dont know what causes autism. Autism is also a psectrum disorder. What works for one indidivudal may not work for another and vice versa.

The game here is standardization for insurance and private entities wishing to get outsourced state contracts as the sole providers for medicare/medicaid assistance and/or insurance coverage.

So it becomes our way or the highway.

There are surgeons who will operate on a person even though the statistics show that the person may have the same chances without surgery. This is the case on many vascular issues.

I know of a sleep doctor who orders sleep test after sleep test on the same people even though the information he needed was available after the first test. When Medicare said they would not pay for 2 different studies done in one night, the sleep center just started having the patients come back a second time. Doctor and hospital make more - more waste of your health care dollars. (This one was a bad call by Medicare and an example of how the hospital/physican worked around the problem.)

Sadly folks, there are physicians out there milking the system. Everybody's trying to milk the system now so they can get paid. Medicine and health care in this country is more screwed up than you can even imagine. electronic medical records are not going to help much at all. They will just increase the cost to providers.

Basing payment on individual outcomes, though would be unfair practice because there are so many variables both in and out of the control of each individual patient.

I am hypothyroid and the medication situaiton is a joke. Low cost, more effective treatments were crushed into near non-existence by the pharmaceutical companies through the heavy lobbying and bribing of doctors. There were no patent rights available on the natural thyroid treatments and it was remarkably cheap as a result. Their treachory left the hypothyroid community with fewer and less effective options.
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I would offer these thoughts.

The problem, as has been mentioned, isn't so much the study. In fact, the only way we will get head to head data on many drugs is a government funded study. No drug manufacturer wants to fund a study that might show their own product to be inferior.

Knowing how to interperet the data and using it as part of deriving wise policy is another matter.

Group statistics say little about the individual patient, and I often have insurance companies refuse to pay for one treatment because they can cite a study showing that a less expensive treatment works in a similar percentage of patients. Well, great, but sometimes my patient isn't one of those for whom the treatment works and they need something different. The way the 'system' works now is that I have to stop what I'm doing, get on the phone, and debate the issue with a technician who usually (at least at the first level, and there can be many levels of appeal) has no medical training and certainly hasn't seen my patient. That's if I can even get through to talk to a human.

It's a great money saver for the insurance industry: by paying a technician's hourly wage, they can stop the doc from delivering further care that day, delay or refuse payment for necessary care, and do it all under the guise of 'ensuring quality health care.'

I think the thing I find most frustrating is that when payment for care or medicine is denied and I haven't yet gotten to make one of these calls, the insurance company often will tell the patient that they aren't getting what they need because the 'doctor didn't do what he was supposed to do.' Great, I'm the bad guy.

Some incredibly useful data could come from such studies, and I look forward to having those data to help guide practice. But, I also know that if something isn't changed, the data will give the insurance industry their most powerful tool yet in their fight to avoid covering, you know, the stuff insurance is supposed to cover.

The FDA, better known as the Foot Dragging Agency, is responsible for hundreds of thousands of deaths. It costs tens of millions of dollars to get a new drug "approved"...if the drug companies don't see a way to make anything off that, they won't bother. After all, they are businesses, not charities. Doctors are (supposedly) not permitted to prescribe any drug for any use other than the "approved" one for an illness, whether or not they know it will work. To put it in the extreme, suppose you discovered that massive doses of Vitamin E would cure AIDS. Firstly, you would have to get FDA approval to prescribe that, which could take years and cost millions. Secondly, since nobody stands to make anything off the discovery, since Vitamin E is plentiful and cheap, this use would never hit the health-care market.

Doctors, at least most of them, know how to be doctors. They studied for a long time, put in the years as residents, and do a damn good job of keeping us alive a lot longer than we would without them.

The real problem is they aren't allowed to practice medicine the way that would be most beneficial to the patient. They have to practice medicine the way that is most beneficial to the HMO, PPO, FFS or POS. They are hog tied by a stystem that wasn't built by doctors. It was built by lawyers and blood thirsty fuckwad insurance companies. Time to put medicine back in medical care.

Oh, and could we get Terry Schiavo's doctor to remove Bleck's feeding tube? He has been clinically brain dead for most of his life and I'm getting sick of seeing his repig face.